The ureters and ureteral cancer
The ureters are small tubes that function to transport urine from the kidney to the bladder. Ureteral cancer is a relatively uncommon form of cancer that typically develops in transitional cells that line the inside walls of the ureters. Because transitional cells also line the inside of the bladder, persons diagnosed with ureteral cancer have a higher risk (50% chance) of developing bladder cancer.
The development of this form of cancer may be influenced by the following:
- Smoking tobacco is the most prevalent risk factor for ureteral and bladder cancer.
- Age – The risk of being diagnosed with this cancer increases with age.
- Gender – Ureteral cancer is more common in older men.
- Bladder or kidney cancer – Persons who have been diagnosed with bladder or kidney cancer have a higher risk of developing ureteral cancer (5-7% increased risk).
- Chemical exposures in the workplace.
As ureteral cancer grows, the mass of cells can disrupt the normal flow of urine, triggering various urinary symptoms. It’s important to have these symptoms assessed by a urologist since many are common to other urological conditions. Symptoms may include:
- Hematuria – blood in the urine. Dark, discolored urine may indicate the presence of blood.
- Back, abdomen, or flank pain.
- Painful urination.
- Passing clots during urination.
- Urination flow that is disrupted.
- Weak urine stream.
- Urinary frequency.
- Urinary urgency.
- Unexplained weight loss.
- Feeling of fatigue.
Treatment options for cancer of the ureters
There are several options available for the treatment of this cancer. These options will be determined based on the size of the tumor, location of the tumor within the ureter, and whether the cancer is localized to the ureter or has spread to other organs. In most cases, patients will be treated with some form of surgery.
When ureteral cancer is diagnosed in its early stages, procedures such as laser therapy or electrosurgery can be utilized. For more advanced tumors, surgical options include:
- Nephroureterectomy– Removal of the kidney, ureter, and a portion of the bladder.
- Segmental Ureterectomy – Removing a section of the ureter that contains the cancerous tumor and reconnecting the remaining ureter.
- Ureteroneocystomy – Removing the cancerous portion of the ureter, then reconnecting it to the bladder.
Following surgery, chemotherapy or radiation may also be indicated depending on the final stage of the cancer.